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HomeMy WebLinkAbout472325 KREUTZMAN CONSTRUCTION INC - INSURANCE CERTIFICATEAC<?R f® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/2/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Beecher Carlson 2002 Summit Blvd Suite 925 Atlanta GA 30319 CONTACT Daniel Gamero NAME: PHONE, ,Ext): (404) 460-1400 �,�• (aoa>a6o-1a3s ADDRIESS:dgamero@gotoalliance.net PRODUCER 00085726 ID # -CUSTOMER INSURER(S) AFFORDING COVERAGE NAIC # INSURED Kreutzman Construction, Inc. Next Generation Energy 75 Waneka Parkway Lafayette CO 80026-2759 INSURERA:Endurance American Specialty INSURER B Allied Group / Nationwide INSURERC:Pinnacol Assurance Com any INSURER D : INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:10-11 All REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADUL SUBR D POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR CC101011063-00 9/1/2010 9/1/2011 I EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 5O , OOO MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ACP 7214135262 6/1/2010 8/1/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Theft Prevention Authority $ Uninsured motorist BI-single $ A j UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE �EXS101011064-00 9/1/2010 9/1/2011 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE - N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4116940 B/1/2010 B/1/2011 IOTH- X TORY TIM TS��_ER E.L. EACH ACCIDENT_ $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1 000 , 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: (job description, number, etc) Certificate holder included as additional insured as respects general liability where required by written contract. This form is subject to policy terms, conditions, and exclusions. City of Fort Collins ,20 Fort Collins��CO 521-2739 L,ANUrLLA 1 IUIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Serro/DGALLr ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD